David M. Reiss, MD

Dr. Reiss is a dad of a 23-year-old son and two stepchildren in their 30s. He is a psychiatrist in private practice in San Diego and was previously the interim medical director of Providence Hospital in Holyoke, Massachusetts.

What’s the one bit of advice about fatherhood you wish someone had given you much earlier? As a father, doctor, and psychiatrist for the past 25 years, I could tell more stories than anyone would be interested in hearing, but I always go back to the words of a psychiatric supervisor during my residency (before my marriage or having children), psychoanalyst James Morris, MD, who gave me what I later came to regard as the wisest advice. Dr. Morris asked me, “Do you know how your children turn out when you treat them with great therapeutic care?” Assuming that as a psychoanalyst, Dr. Morris was going to lecture me on the advantages of therapeutic parenting, but knowing James a bit too well to fall for that, I simply replied, “No.” His response, “They turn out to be patients.”

Having two stepchildren, now in their 30s, who lived with my wife and I since they were in elementary school until they emancipated as adults; and a biological 23-year old son, I can now see (at least partially) what I did correctly and what I did that was not effective — and how in each case, if only I had kept Dr. Morris’ advice in mind.

I must acknowledge that I had the good fortune to have always had a cordial relationship with my stepkids’ biological father, and he has always remained active in their lives, which made the situation much less difficult than others with “blended families” But no family, blended or not, is without its challenges.

What were some of the biggest challenges you faced as a dad, and how did you overcome them? Always having focused my practice on psychiatry, the least difficult aspect for me of being a doctor and a father was avoiding any attempt to diagnosis or treat physical illness or injury beyond minor and common maladies. I certainly used my knowledge to know when to take the kids to the doctor, or a specialist, but I was pretty good at staying out of the way of acting like a “treating” physician.

More difficult was avoiding over-concern and worry, as “a little bit of knowledge is a dangerous thing,” and my medical training made me more aware of possible complications, etc. of even minor problems than was practically or logically reasonable. Keeping my own anxiety in check was at times problematic.

As a psychiatrist, I cannot deny that I used my knowledge of child development to help understand what my children were going through, and I certainly used my understanding to attempt to be more compassionate and helpful. At the same time, I attempted as much as humanly possible not to be “therapeutic.” I recall times I succeeded; I recall times that I failed. Perhaps I can sum up the predicament best in saying that while it would seem that a “therapeutic” parent would have a very positive effect on a child’s development, when you really look at the definition of a “therapist,” you can appreciate why the result of that endeavor is counterproductive.

What’s the most surprising lesson that being a dad has taught you? A therapist is a person who maintains a “neutral” emotional stance, caring about their patient’s wellbeing and caring about the patient as a person, but being careful not to become emotionally attached, not to become involved in a personal relationship, and fastidiously maintaining the boundary of being of professional help while staying out of the patient’s personal life and life decisions (other than regarding medical issues or in situations of obvious danger). A therapist unemotionally observes, evaluates, and (as therapeutically appropriate), comments, interprets and suggests.

That makes a lousy parent! As a father (and stepfather), the emotional connection with your child is much more important than any advice or “interpretation” you can provide. As a father, it is — and it should be — impossible to maintain a “neutral emotional stance” regarding your child. As a psychiatrist/father, it has been useful at times to impart certain factual knowledge and understanding to the kids, but it has never proven effective to be “therapeutic.” Avoiding the trap of being a therapist rather than a father is orders of magnitude more significant when dealing with a blended family and stepchildren, where the roles and boundaries are even more complex and difficult to navigate.

I like to think that my psychiatric knowledge helped me to understand how to become a better parent — far from perfect, but better. Certainly, I cannot totally divorce my psychiatric understanding of certain issues from informing advice that I have given and interventions I have attempted to make. But by all means, I hope that I have succeeded in not being viewed by my kids/stepkids as their doctor, therapist or psychiatrist — which would be a tragic loss to me of the joys (and challenges) of fatherhood and disruptive of their personal development into mature adults.

Profile by Wyatt Myers